Associations between neighborhood disadvantage, cannabis use, and patient-reported outcomes among patients with cancer

Introduction: Cannabis use is proliferating among oncological populations. However, research is limited on whether cannabis routes and sources are associated with neighborhood disadvantage and whether it moderates the relationship between neighborhood disadvantage and patient-reported outcomes (PROs). This analysis evaluates the relationship between neighborhood disadvantage and cannabis source and route, and their association with PROs. Methods: Analyses included 106 patients with cancer from varying levels of neighborhood disadvantage. Logistic regressions tested the association of neighborhood disadvantage with cannabis source (i.e., regulated vs. unregulated) and route (i.e., inhaled vs. consumed/other formulations). Multilevel regressions tested the association of neighborhood disadvantage with PROs (e.g., anxiety, depression, sleep quality, pain, quality of life) and moderation by cannabis variables. Results: Neighborhood disadvantage did not uniquely predict cannabis source or route (p's > .05) or PROs (p's > .05). Conversely, household income predicted pain interference and severity, quality of life, and depression, indicating that lower household income was associated with worse outcomes (p's < .05). There was a significant interaction between neighborhood disadvantage and visit for both pain interference (b=-1.37, 95%CI [-2.4,-0.3], p = .01) and sleep quality (b=1.74, 95%CI [-0.001,3.5], p = .05). Cannabis route significantly moderated the relationship between neighborhood disadvantage and anxiety (b=-5.32, 95%CI [-10.2,-0.4], p = .03). The interaction was driven by reversed scores between patients using inhaled and consumed/other formulations at different levels of neighborhood disadvantage. Conclusion: Although the composite index of neighborhood disadvantage was not associated with cannabis use or PROs, our data suggest that income and cannabis route may be key factors associated with health disparities among patients with cancer.